Case Study Part 1 Questions 1 What organs are located on the left side in the vicinity of the diaphragm 2 What symptoms does Rick exhibit 3 What are the possible diagnoses for Rick s condition at this time For each diagnosis that you come up with describe the symptoms that relate to that diagnosis 4 Was the coach right in his assessment of Rick s condition 1 The organs located on the left side in the vicinity of the diaphragm are the left kidney stomach and spleen 2 Blood was coming out of Rick s lips a bruise was beginning to form around the left side of his diaphragm and his eyes were glazed over 3 The possible diagnoses for Rick s condition at this time Broken ribs Bruises around the left diaphragm and also the bleeding from the mouth could come from one of the ruins rupturing any nearby organs Ruptured spleen bruise around the diaphragm and the bleeding from the mouth Ruptured any organs on the left side of the diaphragm would lead to internal bleeding which could come up from the mouth 4 The coach was not right in Rick s assessment of his condition Part 2 Questions 1 What new symptoms does Rick exhibit 2 Why does Rick feel sick 3 Why is Rick drinking so much water at this time 4 Do you wish to modify your list of possible diagnoses at this time What new information did you use to modify that list 1 Rick s new symptoms that he exhibits are fatigue dizziness pale and dehydration 2 Rick may feel sick due to internal bleeding If he is losing blood that can explain the paleness dizziness and fatigue 3 Rick is drinking so much water at this time due to the loss of blood therefore the body is trying to accommodate for the loss of liquid 4 Due to internal bleeding brought on by the dizziness exhaustion pallor dehydration and injuries to the left side of the diaphragm I do not intend to change my original diagnosis Part 3 Questions 1 What new symptoms does Rick exhibit Case Study 2 Why did Rick faint when he stood up 3 Can fainting be linked to any other of his symptoms 4 Why is Rick s pulse racing 5 Was Rick s father correct to take him to the hospital 6 Do you wish to modify your list of possible diagnoses at this time What new information did you use to modify that list 7 If you were an ER physician what tests would you perform to help narrow the possible diagnoses for Rick s condition 1 Rick s new symptoms are grayness confused devious cough unconscious difficulty breathing sharp pain on left side pulse pounding 2 Rick fainted when he stood up because he lost so much blood Since he lost so much blood not enough blood was circulating to this brain which caused him to faint 3 Fainting could be linked to his other symptoms such as dizziness paleness and dehydration 4 Rick s pulse was racing because his body was trying to pump blood to the places where he lost blood 5 Rick s father was correct to take him to the hospital 6 His coughing elevated blood pressure and difficult heavy breathing suggest a new diagnosis of a punctured lung which might result in collapse 7 A chest x ray would be taken if I were an emergency room doctor to see whether anything was pictured or burst Additionally I would run a CT scan to check for internal bleeding Part 4 Questions 1 Do these results correlate with your initial diagnosis 2 Why is Rick s blood volume low 3 Where did the blood go Do you think that Rick could have lost so much blood from his cut mouth 4 Do you wish to modify your list of possible diagnoses at this time What new information did you use to modify that list 1 These results correlate with my internal bleeding diagnosis and punctured lung diagnosis but it also correlates to a ruptured kidney 2 Rick s blood volume is low due to internal bleeding 3 The internal bleeding is most likely caused from a ruptured organ 4 I would like to modify my diagnosis to a possible ruptured kidney and or punctured lung which can explain all of his symptoms lack of urination internal bleeding which explains the rest of his symptoms including the breathlessness Part 5 Case Study 1 What does Rick s CAT scan of his upper GI indicate about his condition 2 What does Rick s CAT scan of his chest indicate about his condition 3 Do you wish to modify your list of possible diagnoses at this time What new information did you use to modify that list 4 Check the data table and confirm that each entry is consistent with your diagnosis 1 Rick s CAT scan of his upper GI looks normal 2 Rick s CAT scan of his chest appears abnormal and shows that his left leg has collapsed 3 Due to the symptoms and the scans it appears that Rick is suffering from a collapsed lung 4 Everything from the data table corresponds with my diagnosis Part 6 Questions 1 What does Rick s x ray indicate about his condition 2 Do you wish to modify your list of possible diagnoses at this time What new information did you use to modify that list 3 Check the data table and confirm that each entry is consistent with your diagnosis 1 Rick s x ray shows that the left lung collapsed 2 No I do not wish to add or modify my diagnosis 3 Each entry is consistent with my diagnosis Part 7 Questions 1 What is the mechanism whereby Rick s lung collapsed 2 What are the two main problems facing the ER physician 3 What would be your short term and long term treatments for the problem in the x ray 4 Rick was very thirsty after the game and drank a great deal of water that evening Can you Describe the reasons why Rick was so thirsty Relate each answer to Rick s symptoms 5 What would be your short term and long term treatments for the blood volume problem 1 The pleural cavity which is the area between the chest wall and the lung was perforated when Rick was first struck in the check As air pushed on the exterior of the lung from this hollow the lung collapsed 2 The two primary issues the ER physician is dealing with are low blood pressure and cardiac shock brought on by an accelerated heart rate The inability of the heart to pump enough blood can potentially contribute to cardiogenic collapse 3 Short term treatments Oxygen will be required for Rick It will be necessary to use a syringe to remove the air since it is immediately dangerous to have air around his lung Case Study Long term treatments In order to ensure that Rick doesn t have a collapsed lung again Rick s collapsed lung will need to be fused together with a chemical that forms a …